Abstract Heart failure (HF) is a common condition that represents the end stage of cardiovascular diseases (CVDs) subsequent to progressing myocardial damage or ischemia. In populations at ages 65 and older, coronary artery disease (CAD) serves as the leading cause of HF. Although low left ventricular (LV) ejection fraction (EF) is a major evidence for the diagnosis of HF in clinical practice, impaired regional myocardial dysfunction is expected to present the existence of CAD in its early stage. Heart deformation analysis (HDA) is a cutting-edge myocardial motion analysis technique that is able to automatically track the myocardium borders on time frames and calculate global and regional cardiac functional and motional indices on existing cine images without extra scans. In the present study, we will use the HDA tool to analyze existing cine images of CHARISMA study. From 2009 to 2012, cardiac MRI exams (including coronary wall imaging and cine MRI at two-chamber, four-chamber and short-axis views) and concurrent tests for traditional cardiovascular risk factors were performed on 440 older participants (age: 65 - 84 years old at the time of MRI scans) without documented history of CVDs. During the present R03 project (2019-2021), CHARISMA participants would have been followed-up for 10 - 12 years. We plan to relate newly- acquired regional myocardial motion indices (displacement, velocity, strain and strain rate) to clinical outcomes, existing coronary wall measures and results of lab tests in CHARISMA datasets. We will test the overall hypothesis that regional myocardial motion indices have the potential to present cardiovascular risk in asymptomatic elderly. Three specific aims are: 1) Predict cardiovascular events using baseline regional myocardial motion indices; 2) Relate regional myocardial motion indices to MRI-derived features of coronary remodeling; and 3) Determine correlations between regional myocardial motion indices and traditional cardiovascular risk biomarkers/conditions collected in CHARISMA study. No new MRI scans or lab tests are required in this project. Through a cost-effective approach, the immediate objective of the proposed project is to evaluate the clinical value of regional myocardial motion for cardiovascular risk stratification in asymptomatic older adults, a major target population of cardiovascular prevention. This study will also help us better understand the correlations between impaired myocardial function/motion and subclinical CAD burden. Furthermore, the results will facilitate the selection of quantitative imaging biomarkers and their optimal cut-off points for predicting cardiovascular events in future clinical studies.